P - 79645. REQUEST FOR ELECTRICAL INSPECTION T
� Minnesota Board of Electricity �
��� O�- 5 7 2 �° 182� Universiry Avenue Suite S-128, Saint Paul, Minnesota 55104
�: �°� (651) 642-0800 TTY/MRS 1-800-627-3529
www.electricity.state.mn.us •�� t�'
IdentiTy the work covered by this request: �� Y� ,.1 �: ��„,, ,n .�..,� ' U��
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❑NEW REMODEL ❑ADDITION ❑REPAIR �(`�
GENERAL FEES Outdoor Liohtina tandard � Qi
401 to 800 Am ere �$50
Above S00 Am ere � $75
CIRCUITS / FEEDERS
0 to 200 Am ere �$5
Above 200 Am ere � $10
ALARM, COMMUNICATION, REMOTE CONTROL,
CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS
Each Svstem Device or Aoparatus �$.50
to 12 Units �$50 Per Unit
ich Additional Unit � $25
OTHER ADDITIOI
�hting Retrofit � $.25 per Fixture
�nter Pivot IrrigaHon Boom � $4(
anufactured Home Park Lots � $
;creational Vehide Park Sites �
;parate Bonding Inspectlon � $2i
iecial InspecUon � $30 per Hour
ieaal Inspection � $.31 oer Mile
Traffic Si nal Standard � $5
Su demental Fee � $20
Transformers u to 10 KVA (� $10
Trans(ormers over 10 KVA � $20
Transformer / Power Su I for Si ns / Outline Li htin �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Supply up to 500 Amperes, All
Circuits and Two Inspectlon Tri s Each Dwellin Unit (� $80
Additional Insoection Trios � $20
Fee
total fee is
I insoected the eiectmxl ir�siallation� �escribed herein on Ure �tes stated:
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FOR OFFICE USE ONIY ! �
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Reauest Date: . Rouah-in Insoection Reauired? fl Ves Ne InsoecHon bther Than Rouah-In: fl Readv Now Will Ca
�("��` I j"�(� Q� � You must call the inspedor when readyl � Date Ready: ' � �
I certity that I am the �ICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the eiechical work at: